2016-11-08T14:35:53-06:00 2015-12-31 382475073 ANDERSON TUCKEY BERNHARDT & DORAN PC 715 E FRANK STREET CARO MI 48723 990 2015-01-01 383426063 CARO COMMUNITY HOSPITAL CARO 9896733141 401 HOOPER STREET PO BOX 435 CARO MI 48723 MARC AUGSBURGER PRESIDENT AND CEO 9896733141 2016-11-15 true TIMOTHY D FRANZEL P00851336 9896733137 2016-11-08 2015 2017-02-10 21:41:12Z MARC AUGSBURGER 401 N HOOPER PO BOX 435 CARO MI 48723 13913591 false X WWW.CCH-MI.ORG X 1999 MI CARO COMMUNITY HOSPITAL, A COMMUNITY-MINDED HEALTHCARE SYSTEM, IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE. 9 7 169 0 115997 28117 12702016 13636372 7722 16360 198793 232742 13024528 13913591 0 0 7045479 7445704 0 0 5099566 5615551 12145045 13061255 879483 852336 8266785 8822733 3711888 3346374 4554897 5476359 CARO COMMUNITY HOSPITAL, A COMMUNITY-MINDED HEALTHCARE SYSTEM, IS DEDICATED TO PROVIDING COMPASSIONATE CARE AND SERVICES TO ENHANCE THE HEALTH OF ALL THE PATIENTS WE SERVE. false false 8623577 13636372 PROVISION OF NEEDED MEDICAL SERVICES TO THE COMMUNITY. 8623577 true true false false false false false false false false true false false true true false false false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 45 0 true 169 true false false false false false false false false false false false false X 9 7 false false false false false false false true true false false true true true true false false true false false MI X X RONALD SREBINSKI CFO 9896733141 401 HOOPER ST CARO MI 48723 MARC AUGSBURGER PRESIDENT AN 40.00 4.00 X X 210897 0 42791 RUBY REID SECRETARY X X 0 4002 0 DAN BRISTOL CHAIRMAN X X 0 0 0 DR ALFONSO FERREIRA TRUSTEE X 0 0 0 JOHN HUNTER TRUSTEE X 0 0 0 RAYMOND BATES VICE CHAIRMA X X 0 0 0 RICK FULTON TRUSTEE X X 0 0 0 LAINEY RANSFORD TRUSTEE X 0 0 0 ROBERT WOLAK TREASURER X 0 0 0 RONALD SREBINSKI CFO 38.00 X 117190 0 16162 KELLY WHITTAKER DR NURSING 40.00 X 105042 0 14686 GARY RAYMOND PT THERAPIST 40.00 X 103013 0 33486 536142 4002 107125 4 false true false HOSPITAL MD 200 W PARK DRIVE STE 325 PEACHTREE CITY GA 30269 E.R. PHYSICIANS 696000 1 28117 12602 28117 NET PATIENT SERVICE REVENUE 13636372 13636372 13636372 16360 16360 122331 122331 122331 122331 8411 8411 8411 OTHER 76835 76835 CAFETERIA 21643 21643 HPSA PAYMENTS 3522 3522 102000 13913591 13885474 X 5397371 3022528 2374843 187320 187320 1484928 831560 653368 376085 210608 165477 81642 81642 29600 29600 4409588 3668046 741542 84598 84598 29537 29537 70097 11272 58825 71019 71019 715103 467320 247783 124367 124367 13061255 8623577 4437678 0 2197420 2567983 348629 488073 295232 395885 64068 113020 14655691 9983036 4845445 4672655 515991 585117 8266785 8822733 467684 531935 128901 1655722 1271649 1459581 1542790 3711888 3346374 X 4038906 4891242 515991 585117 4554897 5476359 8266785 8822733 852336 69126 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 149292 149292 5779603 3048903 2730700 12112 12112 8714684 6922021 1792663 4672655 INTEREST IN NET ASSETS OF FOUNDATION 585117 585117 ESTIMATED THIRD-PARTY SETTLEMENTS 815324 ACCRUED LIABILITIES 727466 1542790 true true true X true X true true false false 184780 184780 0.01410 2880185 1512938 1367247 0.10470 3064965 1512938 1552027 0.11880 96261 96261 0.00740 96261 96261 0.00740 3161226 1512938 1648288 0.12620 24 507 73513 19255 54258 0.00420 24 507 73513 19255 54258 0.00420 true 323069 96261 5638982 5425065 213917 true true 1 1 CARO COMMUNITY HOSPITAL 401 N HOOPER ST PO BOX 43 CARO MI 48723 X X X X CARO COMMUNITY HOSPITAL 1 false false true X X X X X X X X X X 13 true false false true X WWW.CCH-MI.ORG X true 13 true WWW.CCH-MI.ORG false false true X 150.000000000000 250.000000000000 false false true X X false X false true false false FACILITY 1, CARO COMMUNITY HOSPITAL - PART V, LINE 5 PARTICIPANTS INCLUDED CCH BOARD MEMBERS, CCH STAFF INCLUDING CLINICAL AND ADMINISTRATIVE PERSONS, THE OWNER OF A LOCAL FREE HEALTH CLINIC, TUSCOLA COUNTY HEALTH DEPT, MICHIGAN STATE UNIVERSITY EXTENSION, TUSCOLA INTERMEDIATE SCHOOL DISTRICT, GREAT START COLLABORATIVE, HOSPICE AND HOME HEALTH CARE EMPLOYEES, A LOCAL MEDICAL SUPPLY COMPANY, LOCAL MRI SERVICE, A LOCAL MINISTER, SENIOR CITIZENS, AND COMMUNITY MEMBERS. FACILITY 1, CARO COMMUNITY HOSPITAL - PART V, LINE 11 SURVEY WAS COMPLETED IN NOVEMBER 2013, FOLLOWED IN 2014 AND 2015. PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE THE HOSPITAL UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CHARITY SERVICES. PART I, LINE 6A - RELATED ORGANIZATION INFORMATION THE ANNUAL COMMUNITY BENEFIT AMOUNT RELATES TO THE VALUE OF SALARIES AND FRINGE BENEFITS OF THE HOSPITAL HEALTH SERVICES DEPARTMENT WHICH PROVIDES SPECIALITY PHYSICIANS TO THE CARO COMMUNITY BY RENTING CLINIC SPACE AND PROVIDING RECEPTIONIST SERVICES TO THE PATIENTS OF TUSCOLA COUNTY AREA WHO WOULD HAVE TO DRIVE 35 TO 50 MILES OR EVEN TAKE THE DAY OFF FROM WORK TO RECEIVE ROUTINE SPECIALIST PHYSICIAN SERVICES. 120,364. ALSO, THE COMMUNITY BENEFIT COST ASSOCIATED WITH PARTICIPATING IN BLOOD DRIVES, DOING SPORTS PHYSICALS, COMMUNITY CRAFT PROGRAMS, SENIOR FAIRS, HEALTH EVENTS AT THE FAIR, DISCOUNTED LABS, HOSPITAL AND AROUND THE CARO AREA IS 9,700. TOTAL COMMUNITY BENEFIT VALUE IS 130,064. PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION N/A PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE N/A PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO INDIVIDUALS THAT MAY QUALIFY FOR CHARITY CARE WAS CALCULATED BASED UPON THE AMOUNT OF SELF PAY EMERGENCY ROOM PATIENT CHARGES TIMES 34%, WHICH IS THE AMOUNT THAT PATIENTS WOULD QUALIFY FOR A DISCOUNT. THE BALANCE OF THE PATIENT ACCOUNTS WOULD THEN BE SUBJECTED TO CHARITY CARE GUIDELINES OF EARNINGS OF 250% OR LESS OF THE FEDERAL POVERTY GUIDELINES. 96,261. THE COSTING METHOODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN LINES 7 (A)-(D) IS BASED ON THE COST-TO-CHARGE RATIOS. LINES 7(E)-(I) IS BASED ON ACTUAL COST 54.35% IN 2015 & 51.56% IN 2014. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED ATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED UPON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. THE HOSPITAL COST TO CHARGE RATIO IS UTILIZED IN DETERMINING THE COST OF BAD DEBTS. BAD DEBT EXPENSE INCLUDED ON FORM 990 PART IX LINE 25 THAT IS REMOVED FOR PURPOSES OF SCHEDULE H LINE 7 COLUMN F IS 594,424. COST OF THE NET BAD DEBT EXPENSE IS 323,069. THEREFORE THE COST IS AT 54.35%. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION IF THE PATIENT IS NOT ABLE TO MAKE PAYMENT ARRANGEMENTS, THE STAFF WILL VERBALLY DETERMINE IF THE PATIENT IS POTENTIALLY ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL CHARITY CARE POLICY. PATIENTS WHO APPEAR TO MEET THE CARO COMMUNITY HOSPITAL CRITERIA ARE REFERRED TO THE SOCIAL WORKER FOR FURTHER REVIEW IN ACCORDANCE WITH THE HOSPITAL CHARITY CARE POLICY. PART VI, LINE 2 - NEEDS ASSESSMENT ORGANIZATION COMMUNICATED WITH STATE AND LOCAL AGENCIES TO DETERMINE THE HEALTHCARE NEEDS OF THE COMMUNITY. EXAMPLES OF SERVICES PROVIDED BASED ON COMMUNITY NEEDS ARE IMMUNIZATIONS, VACCINES, SPOTS PHYSICALS, SENIOR AND HEALTH FAIRS, FIRST AID BOOTH, AND DIABETIC CLASSES. CARO COMMUNITY HOSPITAL HAS CURRENTLY JOINED THE MICHIGAN RURAL HEALTH GROUP WHO WILL CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE HOSPITAL IN 2013. THE HEALTH NEEDS ASSESSMENT WAS DONE NOVEMBER OF 2013 AND IS POSTED ON CCH PUBLIC WEBSITE. IT IS A BOARD AGENDA ITEM DURING 2014 AND 2015. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE EVERY UNINSURED PATIENT THAT IS AN INPATIENT, OUTPATIENT, SURGICAL, OBSERVATION, OR INCURS MORE THAN 5,000 IN MEDICAL EXPENSES, RECEIVES A CHARITY CARE PACKAGE. THE PACKAGE INCLUDES A CHARITY CARE AND MEDICAID APPLICATION AND A HUMAN SERVICES REFERRAL FORM. ALL OTHER NON-INSURED PATIENTS MAY REQUEST A CHARITY CARE APPLICATION AT ANY TIME. PART VI, LINE 4 - COMMUNITY INFORMATION ORGANIZATION IS LOCATED IN TUSCOLA COUNTY WHICH HAS A POPULATION OF APPROX. 56,500, CARO HAS A POPULATION OF APPROX 4,250. TUSCOLA COUNTY CONSISTS OF MOSTLY FARMLAND WITH VERY FEW MANUFACTURING FACILITIES. THE UNEMPLOYMENT RATE IN TUSCOLA COUNTY IS HIGH BECAUSE OF THE LOSS OF MANY SMALL AUTOMOTIVE RELATED JOBS AND IS AT OR ABOVE THE STATE OF MICHIGAN'S UNEMPLOYMENT RATE. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH ORGANIZATION PROVIDES SPECIAL CLINICS IN CARO SO PATIENTS DO NOT HAVE TO COMMUTE. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM N/A PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT MICHIGAN ADDITIONAL INFORMATION ALL PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE OF AN EXTENDED PAYMENT PLAN DEPENDING ON THE DOLLAR AMOUNT OF THE BILL OWED. IN 2015 EMERGENT PATIENTS WITHOUT ANY TYPE OF COVERAGE WERE ALSO EXTENDED A 34% DISCOUNT PLUS OFFERED AN EXTENDED PAYMENT PLAN IF NEEDED. THE DISCOUNT PLAN ESTABLISHED IN 2012 AND REVISED IN 2015 WAS BASED ON THE AVERAGE TOTAL COMMERCIAL COVERAGE AND ONE GOVERNMENT PLAN WHICH WAS WORKERS COMPENSATION AND THE AVERAGE CAME TO 34% DISCOUNTED. X X false false false false false false false false false MARC AUGSBURGER PRESIDENT AND CEO 210897 9462 33329 253688 FORM 990, PAGE 6, PART VI, LINE 11B EACH BOARD MEMBER WILL RECEIVE A COMPLETE COPY OF THE RETURN. THE CEO AND CFO WILL REVIEW THE RETURN DURING THE NOVEMBER MEETING OF THE BOARD OF TRUSTEES. FORM 990, PAGE 6, PART VI, LINE 12C THE CONFLICT OF INTEREST POLICY IS MONITORED THROUGH DISCUSSION WITH THE CEO AND EACH BOARD MEMBER. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD UTILIZES THE MICHIGAN HEALTH AND HOSPITAL ANNUAL SURVEY TO DETERMINE THE COMPENSATION LEVEL FOR THE CEO. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART IX, LINE 11G DUES AND SUBSCRIPTIONS 97,516 0 0 SUPPLIES 1,459,290 228,267 0 PURCHASED SERVICES 207,473 289,957 0 STATE OF MICH QAAP TAX 312,366 0 0 UTILITIES 219,449 0 0 REPAIRS AND MAINTENANCE 205,090 223,318 0 OTHER 102,374 0 0 PROFESSIONAL FEES 1,064,488 0 0 FORM 990, PART XI, LINE 9 NET CHANGE IN CCH ENDOWMENT FOUNDATION 69,126 TOTAL 69,126 CCH HEALTH CARE ALLIANCE 401 N HOOPER STREET CARO MI 48473 383426058 PARENT MI 501C 3 N/A false CCH ENDOWMENT FOUNDATION 401 N HOOPER STREET CARO MI 48473 382422995 FOUNDATION MI 501C 3 N/A false false false false false false false false false false false false false false false false false false false false